Outline

Heart fibrosis and alterations in the cardiovascular system autonomic control are the pathomechanisms of potentially fatal arrhythmias in course of systemic sclerosis (SS). Elevated serum catecholamines, abnormal non-invasive tests of autonomic nervous system functioning and decreased heart rate variability (HRV) account for autonomic system impairment in SS patients. HRV parameters are regarded the reliable risk predictors of death in ischemic and other heart diseases. Recently, heart rate turbulance (HRT) was introduced for assessing cardiac function. Value of turbulence onset (TO) over 0% and turbulence slope (TS) <2,5 ms per RR interval were found to be good death predictors in patients with previous myocardial infarction (MI). Aim of the study was to investigate the parameters of HRT in the patients with SS.

Material and methods: The examined population consisted of 25 patients (16 women and 9 men; aged 21–77 years) with clinically established diagnosis of SS. According to the American Rheumatism Association criteria, limited form of SS was diagnosed in 14 patients and diffuse form in the rest 11 patients. The patients were subjected to the routine examinations: ECG, 24-hour ECG, echocardiography, chest X-ray and pulmonary functional tests. The tests did not reveal any evidence of severe cardiac or pulmonary involvement in the SS patients. Then, HRT parameters: TO and TS, were calculated, using the recordings obtained from 24-hour ECG Holter monitoring.

Results: TO parameter appeared to be over 0% in the three (12%), and TS parameter <2,5 ms per RR interval in the two (8%) out of the 25 SS patients. One subject revealed the both parameters out of the normal limits.